Biomedical Engineering – From Theory to Applications

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334 Biomedical Engineering – From Theory to Applications Unless effective counter-measures are taken, pressure discontinuities can arise, especially at hinge positions and/or latch positions. This gives rise to the possibility of continued marginal blood flow at these points. In terms of infection, such marginal leaking is exceptionally dangerous. A good design for an ischaemic necrosis clamp is one that has no discontinuity in the clamping ring and which, throughout the wear period, maintains an absolutely even pressure sufficient to bring about total cessation of blood flow across the whole of the intended scar line. Resistance to premature removal by a meddlesome patient: Premature removal of an ischaemic necrosis clamp can precipitate a clinical emergency. Therefore it is vital that the latching mechanism of the clamp should be secure against tampering. The risk of such tampering is greatest when dealing with post-infancy paediatric patients. Minimum requirement for pre-treatment: In the world of veterinary medicine, immunization against tetanus is recommended when ischaemic necrosis is used for procedures such as tail docking of lambs by means of the Elastrator device (Thedford, 1983). We commend the idea of similar pre-treatment before any ischaemic necrosis procedure is used for MC. Cultural acceptability: A whole raft of issues can arise here, any one of which might scupper a proposal to use a particular design of clamp in a particular area. For example, is a device invented in Israel assured of acceptance in Islamic Republics that do not even acknowledge the existence of the Jewish state? Will circumcision ever be accepted by Hindus, many of whom value their foreskins as evidence of not being Muslim? During the partition of India in 1947, strangers suspected of being of the opposite faith were disrobed and put to death on no more evidence than their circumcision status (Kamra, 2002). Rather less dramatically, there is the question of whether a clip-&-wear clamp protrudes beyond the end of the penis during the wear period. Not a problem in societies where loose, flowing robes are normal attire, but an entirely different matter when the male is habitually dressed in tight jeans. 10. Resulting new designs for circumcision devices The authors are aware of eight products designed to fulfil the demand for a field-use device, all being either in full production or in the final stages of development and testing. These are now considered individually, in alphabetical order of trade name. Only the original patents or patent applications in the inventor's country of residence are listed; increments may exist in the same country as well as there being patents elsewhere. It should be noted that some clamps have been the subject of ongoing development after their initial market launch. Care is needed when reading reports of field trial results. Early criticisms may have been rendered obsolete by subsequent design changes. 10.1 AccuCirc Inventor: Tomlinson, D.R. Primary patent: US2005/022404 Patent priority date: 25 Jun 2004 Patient age range: Full-term neonate only Website: http://www.accucirc.com Category: Automated cutter
Male Circumcision: An Appraisal of Current Instrumentation Fig. 9. The AccuCirc device. Procedure: The AccuCirc uses two innovative components, a Foreskin Probe/Shielding Ring that ensures the glans is protected with the foreskin properly aligned and a Single-Action Clamp that ensures adequate haemostasis and the precise delivery of the protected, circular blade. These work together to protect the infant from injury. This device simplifies the circumcision procedure and eliminates the need for a dorsal slit, as well as removing potential for mismatching of parts. It comes in a self-contained kit. This is completely disposable and no part is retained on the infant. 10.2 Ali's Klamp Inventor: Canoğlu, V.A. Primary patent: TR2003/00403 Patent priority date: 28 Mar 2003 Patient age range: Full-term neonate to adult (experimental in adult sizes) Website: http://www.alisklamp.com Category: Ischaemic necrosis device Fig. 10. Ali’s clamp. Procedure: The Ali's Klamp (a.k.a. “Alisklamp” and “Ali’s clamp”; Telif Haklari ABAGROUP Ltd) is a single-use ischaemic necrosis device; the foreskin is crushed between two plastic surfaces. The recommended procedure includes severing of the excess tissue. During that process, the tube protects the glans from accidental injury. Note that the final scar line forms at the position of the clamping ring, not at the position of the scalpel cut. In theory the user 335
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BIOMEDICAL ENGINEERING - FROM THEOR
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VI Contents Chapter 9 Targeted Magn
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X Preface stand-alone and readers c
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6 Biomedical search engine Scientif
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12 Bireme http://regional.bv salud.
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108 Method (Detection) CIEF-tITP-CZ
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110 Method (Detection) Analyte Matr
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120 6. Conclusion Biomedical Engine
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150 5. Conclusions Biomedical Engin
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162 1 st phase : half year 4 2 nd p
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166 7. Innovative active training B
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172 12. Maturing projects’ story
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180 16. Acknowledgments Biomedical
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190 R* M M M M MR*M O O O O M O R*
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196 Fig. 9. Chemical structure of 5
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198 Relative Intensity (AU) Biomedi
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204 2. Preparation of IO nanopartic
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256 3. Deposition techniques Biomed
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